america's voices aligned for health - #ava4h

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American Voices – Aligned for HealthGreg MatthewsFebruary 26, 2013

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“ “My use of twitter allows me to expand the diversity of my

network, and therefore my knowledge in my areas of

interest : prevention, diversity/equity, integrated care, and

Washington, DC (the #epicenter!).

It also allows me to model open leadership as a

physician, and promote this approach among my medical

and nursing colleagues. Ted EytanFamily Medicine, Kaiser Permanente

twitter.com/tedeytan

linkedin.com/in/tedeytan

tedeytan.com

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Internet users are searching for health info

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72%

140 Million American Adults

Pew Internet and American Life – Online Health 2013

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Self-diagnosis is mainstream

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Pew Internet and American Life – Online Health 2013

35%of internet users are

considered “self-diagnosers”

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Twitter is an information accelerator

• 25% of physicians use social media daily as an information source*

• Facebook has passed 1B users;• Twitter has surpassed 500M Users

Journal of Medical Internet Research – September 24, 2012

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Tweets Over Time

Trending steadily upward

1 5 9 13 17 21 25 29 33 37 41 45 49 53 57 61 65 69 73 77 81 85 89 93 97 1011051091131171211251291331371411451490

500

1000

1500

2000

2500

3000

3500

4000

4500

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The American Voices study

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AVA4H Data Sets

2.3M

218,934

132,108

36,300*

464,272

71,606

*Journalist-written articles

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5,000

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403,000

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2,300,000

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326,840

Not just tweets this time …

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Making Sense of the Data

19 Contents are proprietary and confidential.

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Topical Breakdown

• CDC Disease list• Broad Health Topics from

Subjects’ tweets

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What we Learned

21 Contents are proprietary and confidential.

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At the highest level …

Health Education

Business of Health

Politics of Health

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At the highest level …

Health Education

Business of Health

Politics of HealthSURP

RISED

?

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Strongest Focus Areas

Doctors

Media

Congress

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

6%

33%

2%

14%

11%

64%

27%

22%

15%

6%

10%

5%47%

23% 15%

Healthcare Conversation Topics

TreatmentResearchPreventionPolicyBusiness

Per

cen

tag

e o

f H

ealt

hca

re C

on

vers

atio

n

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Where education makes a difference

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Making a comeback

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A new #1

Vaccine-Preventable Diseases

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Doctors armed for combat

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Disease Conversation Volume Over Time

04/3

0/08

05/0

5/08

05/1

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05/1

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05/2

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05/2

5/08

05/3

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06/0

4/08

06/0

9/08

06/1

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06/2

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06/2

9/08

07/0

4/08

07/0

9/08

07/1

4/08

07/1

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07/2

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07/2

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08/0

3/08

08/0

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08/1

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08/1

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08/2

3/08

08/2

8/08

09/0

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7/08

09/1

2/08

09/1

7/08

09/2

2/08

09/2

7/08

0

10

20

30

40

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60

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80

90

100

Diabetes Breast Cancer Prostate Cancer

29 Contents are proprietary and confidential.

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The PSA Controversy

117

182

36

Negative Neutral Positive

Doctors who state an opinion are more than

3:1 Againstthe USPSTF’s

ruling on PSA Tests

30 Contents are proprietary and confidential.

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The Voice of the Patient Matters

31 Contents are proprietary and confidential.

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Doctors discuss Breast Cancer and Lung Cancer

Mortality/1,000 Conversation Frequency0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Breast CancerLung Cancer

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HIV/Aids and Heart Disease

Mortality/1,000

MD Media Congress0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

AIDS/HIVHeart Disease

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Vaccines - HPVHPV makes up 18.2% of media vaccine conversations

Doctors

Media

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

95.8%

81.8%

4.2%

18.2%

Other Vaccine Conversation HPV34

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Content Gap Analysis Methodology

• The Content Gap Analysis is a statistical comparison of word frequencies between two corpora of text

• These two corpora are typically either:

• A subset of one corpus compared against the whole corpus

• Two distinct corpora compared directly against each other

• The outcome is a list of words that appear in both corpora with an associated “oddness” score that denotes how much more (or less) each word appears in one corpus versus the other

147 documents1,789 words

Word Frequency

medicine 10

drug 8

vaccine 7

vaccination 7

wellness 6

Word G2

medicine 3.42

drug 2.81

vaccine 1.14

vaccination 1.12

80 documents917 words

Word Frequency

vaccine 6

medicine 6

drug 4

vaccination 3

health 2

ƒ(x)

Corpus 1 Corpus 2

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Interventions – MDs and the Media

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The untouchable – and the social?

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Medicaid and Mandela

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High Risk/Low Effort

• Doctors discuss 67% more than the media;• 483% more than congress

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Insurance and reimbursement

• Congress & the media lead the way in exploring how we’ll pay for care in the future

• Physicians, while concerned about patients’ access to care and the viability of primary care, can be better informed

14%

38%

48%

DoctorsMediaCongress

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Aligning communications – what’s next?

• Patient-centeredness first

• Create more robust and transparent networks (inter- and intra-group)

• Build consensus on the balance between “most important health stories”

• Monitor progress with a public “dashboard”

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Thank you

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Acknowledgements

R&D Lead – Matthew Hager (@iSmashew)

Analyst – Kayla Rodriguez (@Kaylarodrigue11)

Analyst – Dan Zhao (@denzelzhao)

Analytics Design – Seth Duncan (@PRResearch)

Analyst – Emma Ferguson (@EmmaAnAnalyst)

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Appendix

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Physician Profiles

contain a URL in their

bio

80%

identify themselves

clearly as such in their

twitter bio

78%

32%

link to a personal blog or website

46 Contents are proprietary and confidential.

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How are MDs using their accounts?

6.90%

1.90%

31.90%

37.70%

Bio URL Distribution

Business Medical Resource Personal Blog/Website Practice

of all Plastic Surgery URLs are links to their

practice

93%

47 Contents are proprietary and confidential.

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Twitter and the MD Workflow

Morning Workday Work PM Evening Overnight

18% 21% 31% 8% 22%

(0500 – 0800) (0801 - 1200) (1201 - 1800) (1801-2300) (2301-0459)

Localized time

18%21%

31%

8%

22%

0500-0800 0801-1200 1201-1800 1801-2300 2301-0459

48 Contents are proprietary and confidential.

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The Connected Physician

49 Contents are proprietary and confidential.

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Ratio of following to followers

Ratio of Following to Followers

0.- .1:1 .11-.2:1 .31-.7:1 .71-1.5:1 1.51-3.0:1 3.1-11.0:1 11.1-100.0:1 100.1-2808:1

2.80%4.90%

21.50%

32.40%

16.20%14.00%

6.70%

1.60%

Median Ratio 1.1 : 1

50 Contents are proprietary and confidential.

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MDs Most likely to be followed by peers*

53%

40%34%

27%

25%

Personal Blog/Website

Business/ Organization

All_Doctors

No Bio URL

practice

51 Contents are proprietary and confidential.

*Percentages measure MDs followed by at least 20 others in the data set

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How connected are online physicians?

of all MDs are followed

by at least 20 MDs 34%

Pediatrics

Emergency Medicine

Family Medicine

Specialties who are followed by

other MDs

52 Contents are proprietary and confidential.

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Mining the Data

• Breast Cancer: (breast AND (cancer OR carcinoma)) OR (inflammatory AND breast) OR (inflammation AND breast) OR (breast AND (metastasis OR metastic)) OR (duct AND (carcinoma OR cancer)) OR (lobe AND (carcinoma OR cancer)) OR "DCIS" OR "LCIS" OR (estrogen AND receptor AND positive) OR "HER2" OR (breast AND MRI) OR (breast AND biopsy) OR (breast AND ultrasound) OR "mammogram" OR "mammography" OR "tamoxifen" OR (aromatase AND inhibitor) OR "exemestane" OR "trastuzumab" OR "Herceptin" OR "lumpectomy" OR "mastectomy" OR "komen" OR "BRCA1" OR "BRCA2”

• Diabetes: "Diabetes" OR "Mellitus" OR "Insipidus" OR "Diabetic" OR "Gestational" OR "blood glucose" OR "Blood Sugar" OR "NIDDM" OR "IDDM" OR "LADA" OR ("Antiduretic Hormone" OR "ADH") OR ("Arginine Vasopressin" OR "AVP") OR "oral glucose tolerance" OR "fasting plasma glucose" OR "glycated hemoglobin OR HbA1c OR A1c" OR "insulin" OR "SMBG" OR "hyperglycemia OR hyperglycemic" OR "biguanides" OR "Sulfonylureas" OR "Meglitinides" OR "thiazolidinediones" OR "alpha glucosidase inhibitor" OR "GLP-1 agonist" OR "DPP-IV inhibitors" OR "DKA" OR "HHS"

A sample

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All Text CloudsHashtag Clouds

Diabetes & Breast Cancer – Sample Search

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